| NPI | 1871749986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 265288) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA mt193528) |
| Enumeration Date | 2008-08-09 |
| Last Update Date | 2012-08-06 |